Organization
DENTAL EXPRESS MEDINA -JERRY S. KOLOSIONEK DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY R MAUERMAN (EXECUTIVE ADMIN)
(330) 533-3400
Entity
Organization
Contact information
Practice address
750 E WASHINGTON ST, SUITE A3, MEDINA, OH 44256-2196
(330) 725-3887
Mailing address
750 E WASHINGTON ST, SUITE A3, MEDINA, OH 44256-2196
(330) 725-3887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-019480
OH
122300000X
Dentist
30-023197
OH
122300000X
Dentist
30-023233
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1143641-00-3
—
OH
Enumeration date
08/11/2010
Last updated
08/11/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up